TY - JOUR
T1 - Multicenter study of principles-based waveforms for external defibrillation
AU - Bain, Allison C.
AU - Swerdlow, Charles D.
AU - Love, Charles J.
AU - Ellenbogen, Kenneth A.
AU - Deering, Thomas F.
AU - Brewer, James E.
AU - Augostini, Ralph S.
AU - Tchou, Patrick J.
N1 - Funding Information:
Supported by Survivalink Corporation, Minneapolis, MN.
PY - 2001
Y1 - 2001
N2 - Study objective: The efficacy of a shock waveform for external defibrillation depends on the waveform characteristics. Recently, design principles based on cardiac electrophysiology have been developed to determine optimal waveform characteristics. The objective of this clinical trial was to evaluate the efficacy of principles-based monophasic and biphasic waveforms for external defibrillation. Methods: A prospective, randomized, blinded, multicenter study of 118 patients undergoing electrophysiologic testing or receiving an implantable defibrillator was conducted. Ventricular fibrillation was induced, and defibrillation was attempted in each patient with a biphasic and a monophasic waveform. Patients were randomly placed into 2 groups: group 1 received shocks of escalating energy, and group 2 received only high energy shocks. Results: The biphasic waveform achieved a first-shock success rate of 100% in group 1 (95% confidence interval [Cl] 95.1% to 100%) and group 2 (95% CI 94.6% to 100%), with average delivered energies of 201±17 J and 295±28 J, respectively. The monophasic waveform demonstrated a 96.7% (95% CI 89.1% to 100%)first-shock success rate and average delivered energy of 215±12 J for group 1 and a 98.2% (95% CI 91.7% to 100%) first-shock success rate and average delivered energy of 352±13 J for group 2. Conclusion: Using principles of electrophysiology, it is possible to design both biphasic and monophasic waveforms for external defibrillation that achieve a high first-shock efficacy.
AB - Study objective: The efficacy of a shock waveform for external defibrillation depends on the waveform characteristics. Recently, design principles based on cardiac electrophysiology have been developed to determine optimal waveform characteristics. The objective of this clinical trial was to evaluate the efficacy of principles-based monophasic and biphasic waveforms for external defibrillation. Methods: A prospective, randomized, blinded, multicenter study of 118 patients undergoing electrophysiologic testing or receiving an implantable defibrillator was conducted. Ventricular fibrillation was induced, and defibrillation was attempted in each patient with a biphasic and a monophasic waveform. Patients were randomly placed into 2 groups: group 1 received shocks of escalating energy, and group 2 received only high energy shocks. Results: The biphasic waveform achieved a first-shock success rate of 100% in group 1 (95% confidence interval [Cl] 95.1% to 100%) and group 2 (95% CI 94.6% to 100%), with average delivered energies of 201±17 J and 295±28 J, respectively. The monophasic waveform demonstrated a 96.7% (95% CI 89.1% to 100%)first-shock success rate and average delivered energy of 215±12 J for group 1 and a 98.2% (95% CI 91.7% to 100%) first-shock success rate and average delivered energy of 352±13 J for group 2. Conclusion: Using principles of electrophysiology, it is possible to design both biphasic and monophasic waveforms for external defibrillation that achieve a high first-shock efficacy.
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U2 - 10.1067/mem.2001.111690
DO - 10.1067/mem.2001.111690
M3 - Article
C2 - 11145764
AN - SCOPUS:0035154752
SN - 0196-0644
VL - 37
SP - 5
EP - 12
JO - Annals of emergency medicine
JF - Annals of emergency medicine
IS - 1
ER -